مجله طب جنوب
سال شانزدهم شماره 3 (پاییز 1392)

Treg cells are the most potent suppressants of antitumural activity of immune system and expression of CTLA-4 is essential for activation of FOXP3+ T-cells. IL-10 is an immunosuppressor which is one of the major obstacles of specific tumoral T-cells. Objective of this study was comparison of expression of FOXP3، CTLA-4 &IL10 genes among patients with and without laryngeal cancer local metastasis and patients with lymph node ivolvement. 59 patients with laryngeal cancer which 8 of them had lacal metastasis were enrolled in this study. Also 31 samples of lymph node tissues were taken. The percentage and expression of FOXP3، CTLA-4 &IL10 genes were investigated by Real-Time PCR. The results indicated that there were not any significant difference between laryngeal cancer patients with or without local metastasis and also between patients with or without lymph node involvement in percentage of FOXP3، CTLA-4 and IL-10 genes expression (P>0/05). As well as there were no statistical association with the genes expression and different stages and pathological differentiation of tumors (P>0/05). There is no significant association between percentage of expression of FOXP3، CTLA-4 and IL-10 genes in our patients with laryngeal tumor considering local invasion extension and lymph node involvements.

Poly Cystic Ovary Syndrome (PCOS) is the most commonly encountered endocrine gland disease affecting 5-10 present of women at their reproductive age. This syndrome is associated with type 2 diabetes، dyslipidemia، and obesity. Progranulin and relaxin are adipokins that are related with carbohydrate and lipid metabolism. Due to limited data about progranulin and relaxin plasma levels´ in women with PCOS and normal BMI، this study was conducted. This study is a cross-sectional. During the study 39 women with PCOS and BMI< 25 on the basis of Rotterdam criteria were chosen as the patient group and 38 healthy women were selected as the control group. The concentration of progranulin and relaxin were measured by ELISA technique. The difference in Plasma concentration of progranulin and relaxin، and also some of the biochemical parameters in the patient group versus to the control group was not significant، but there was significant difference in the concentrations of VLDL، triglyceride (p=0. 046)، insulin (p=0. 016)، HOMA-IR (p=0. 015)، testosterone (p=0. 01)، and DHEAS (p=0. 034) in the patients group compared to the control group. In this study، the difference in Plasma concentration of progranulin and relaxin in the patient group compared to the control group was not significant. It could be inferred that lack of change in plasma level of progranulin and relaxin in women with PCOS is related to BMI<25 and FBS<110. Moreoverestosterones، insulin، DHEAS and HOMA-IR changes could be better predictors of PCOS and its associated diabetes.

Escherichia coli uropathogen is the most prevalent pathogen separated from urinary tract that often is originated from intestinal flora of the own person. Urinary tract infection is one of the most prevalent infectious diseases in Human. Whereas binding stage has an important role in bacteria colonization and then the infection is created، one of the most important strategies for inhibiting the infection is inhibiting the bacterial binding. As fimH protein is acting as adhesion it could be an appropriate candidate for producingvaccine. First، genomic DNA of Escherichia coli bacteria extracted from strain 35218 ATCC. Upon designing primer for fimH gene، the PCR reaction has been applied with Taq DNA Polymerase and then pfu DNA polymerase enzymes. pBluescript (SK-) plasmid has been applied for cloning the product of PCR. Using ClustalW and MEGA4 software، the subsequence was alignmented with the gene subsequence existing in gene bank and its gene diversity was examined. After sequencing the cloned fimH gene using ClustalW and MEGA4 software، the result of this subsequence were alignmented with the subsequence of Escherichia coli containing fimH gene existing in gene bank and based on this alignment، N terminal on the protein surface and DNA are protected. N terminal domain of fimH gene is a conserved sequence among clinical isolates and it could be used for designing a vaccine against urinary tract infection.

Uterine leiomyoma، usually known as fibroma، is common estrogen-related a gynaecological disease and the most common disorder leading to hysterectomy. It is estimated that one in four women will develop this kind of benign neoplasia during their reproductive period، therefore، it is considered to have significant effect women’s health. This study aimed to evaluate association of estrogen receptor a (ERα) -351 A>G (XbaI) and -397 T>C (PvuII) gene polymorphisms with uterne leiomyoma in Chaharmahal & Bakhtiari’s women. 156 women with clinically diagnosed uterine leiomyoma and 151 healthy، normal women were included in this case – control study. ERα-351 A/G XbaI and -397 T/C PvuII polymorphisms were assessed by the method of PCR-RFLP. Collected data were analyzed by SPSS ver. 17 software، using chi square tests. Genotypes and allelic frequencies in each group were compared. The genotype/allele frequencies of Era -351 A>G and -397 T/C polymorphisms in leiomyoma groups were not different from those of normal controls sinificantly. We concluded that ERα -351 XbaI A>G and -397 PvuII T>C related genotypes/alleles were not associated with an increased risk of uterine leiomyoma in study population.

Coffee is a traditional drinking used by most of the people around the world. Overuse of coffee leads to many side effects on body. In this study، the effect of different doses of coffee extract on kidney volume was studied by the stereological method. Sixty spragu-dawley male rats were divided into 6 groups. Control group was given tap water (0. 5ml) and experimental groups were given coffee extract orally for 14 days with doses (0. 125، 0. 25، 0. 5، 1، 1. 5gr/kg) with the same volume of control group. Then rats were anesthetized (with ether)، sacrificed and their right kidneys were removed، fixed، tissue processed and stained with H&E. The 5µm slides were studied by Cavalieri principle. Higher doses of water coffee extract were associated with decreased kidney volume and volumes of glomerules but in lower doses it increased related to control group. It seems that، high doses of coffee has side effect on kidneyand reduces volume of kidney and its glomerules. However further studies are required to confirm this research.

The hemotoxic and neurotoxic factors of snake venoms is the main responsible for necrosis and tissue sloughing. Envenomations are common in rural areas in all provinces of Iran caused by snake species which causes local swelling، ecchymosis and alterations in blood profile in case of hemotoxic venom. In this study some in vivo and in vitro properties (Hemorrhagic، edematogenic and coagualant) of Iranian Vipera lebetina venom in addition to neutralizing capacity of pepsin derived Razi Institute polyvalent antivenin were assayed. Escalating doses of Vipera lebetina venom dissolved in Normal saline (2. 5-50 µg/ml) were injected (100µl) subcutaneously to dorsal area of rats (n=3) to investigate mean hemorrhagic amount after 24 hours. Groups of three mice were injected subcutaneously in the right foodpad with various amounts of venom (10-150µg). The left foodpad received the same amount (100µl) ofnormal saline alone (negative control) to evaluate the edematogenic property of this venom. To determine the coagulant activity، various amounts of venom dissolved in normal saline (50µl) were added to human plasma (200µl) and coagulation time was measured. Razi Institute antivenom was used for neutralization of all three measured biological parameters. Mean hemorrhagic، procoagulant and edematous amounts (increasing 30% in hind paw edema) were 8. 5، 1. 1 and 70 microgram، respectively. Preincubation with polyvalent antibody (30 and 200 microliter) decreased hemorrhagic and procoagulant activity. Edematogenic property of this venom decreased significantly by incubation with antivenom (78% to 38% by incubation with 1000 microliter of polyvalent antivenom). Intra peritoneal injection of this remedy following envenomation had no effect in relieving symptoms. Myonecrotic effects were seen by intramuscular injection of Vipera lebetina venom in rats. Our study shows that Iranian antivenom could neutralize some in vivo and in vitro hazardous effects of envenomation by this snake like hemorrhagic، edematogenic and procoagulant properties that paves the way for separation and purification of multiple enzymes present in this venom to investigate the neutralizing capacity from Razi Institute polyvalent antivenom.

In the human body، there are some special systems to interact with pathogens of free radicals that are called antioxidant immune system in some human diseases. Diabetes is one of the most important common chronic diseases with changing in antioxidant capacity. Therefore، this research was done with the purpose of determination and comparison of antioxidant capacity of diabetic patients، saliva with control Grope. This study was a case control study. 50 people with type II diabetes referring to Zahedan diabetic center assigned as case group، they were compared with 50 participants from control group. Both groups had similar age، sex and all other criteria. Total antioxidant capacity of saliva evaluated with FRAP (Ferric reducing ability of plasma) method. The data was analyzed by T-test and ANOVA. Mean and standard deviation (Mean ± SD) of antioxidant capacity of saliva in case group was 0. 442±0. 251 µmol/liter and in control group was 0. 667±0. 421 µmol/liter. Reduction of antioxidant capacity of saliva of case group was statistically significant using T-test and ANOVA analysis (p=0. 002). In this study reduction of antioxidant capacity of diabetic patients، saliva was significantly lower than control group. Therefore، it is recommended that these people use more natural antioxidants.

There is need to develop updated database related to malaria mosquito، because there is back prevalence of malaria in the past two decades in some areas of north and northwest of Iran categorized as epidemiologically clean areas previously. Vectors control is one of the main strategies in controlling the epidemics. In this study، species composition and monthly activity of anopheles mosquito larva in different breeding places in Qom province was assessed. The present study was a cross-sectional one. It was carried out in all 5 parts of geographical areas of Qom province. Samples were collected every 15 days from the natural and artificial breeding places from April to October 2010، using dipping standard method of WHO. Mosquito larvae conserved in lactophenol medium. In the laboratory، the specimens were mounted in likidophor medium and microscopic slides were prepared from larvae، and identified using illustrated keys for Iranian mosquitoes. A total of 298 larvae samples were collected and identified from different breeding places in various areas of Qom province. This larvae belonged to two subgenus of Anopheles and Cellia and including four species of An. (Ano.) marteri، An. (Ano.) claviger، An. (Cel.) superpictus، and An. (Cel.) turkhudi. An. (Ano.) claviger، An. (Ano.) marteri، and An. (Cel.) turkhudi are reported for the first time in this province. An. (Ano.) claviger was dominant species of larvae in the breeding places in Qom province and found in different larva habitats. The peak of activity of recent species is in late July and early August and its seasonal activity is in late April to late October. An. (Cel.) superpictus which is Malaria vector in different parts of the world and Iran is the dominant species of the area had the second frequency. Having high potential for transmission and possibility of establishing a transmission cycle with low abundance is the characteristics of first species. Anopheles claviger also has the transmission potential and was caught in Persian Gulf area. Specific studies such as determination of biting and resting habits and host preference of adult mosquitoes in this area is recommended.

Oral and dental health are among the most important aspects of individual health. Thus، it is necessary to determine community’s oral health status. Various epidemiological studies are required at different levels to assess the efficacy of preventive، oral and dental health control programs in a society. Complications such as nutritional adverse effects، periodontal diseases and adverse psychological effects of dental caries and etc. could be prevented by in-time diagnosis and treatment. This study aimed to assess DMF، dmf index and periodontal status in 6-12 year-old students in Kermanshah City in 2009. This was a descriptive cross-sectional study. Data were collected through interview and dental clinical examination using disposable dental explorer، dental mirror، periodontal probe، a flash light and a marker. Data were entered into a questionnaire containing demographic characteristics and oral and dental health status of subjects (WHO oral health assessments form). A total of 1050 students aged 6 to 12 years were evaluated for their oral health status in Kermanshah City. Data were analyzed using SPSS version 14 software. T-test and chi square test were also used for analysis. A total of 50% of boys and 52% of girls were susceptible to dent facial problems due to caries، extraction، premature loss of deciduous teeth، and congenital or acquired maxillofacial problems following conditions like mouth breathing due to adenoid and etc. Overall، 18. 3% of 6 year old students were caries free. Among middle school students، DMFT was 1. 65±1. 82 and 3. 88±2. 72 among female and male 12 year old students، respectively. In general، 19. 8% of elementary and 16. 8% of 12 year old students had clinically healthy gingiva; 21. 6% of 6 to 12 year old students did not brush their teeth. A significant correlation was found between the frequency of tooth brushing per day and mean dmft، mean DMFT and gingival health (P<0. 05). Also، a significant association was detected between frequency of tooth brushing per day by the students and frequency of brushing by their parents. Such correlation was also observed between the frequency of brushing by the mother and father (P<0. 05). Prevalence of dental caries among 6 to 12 year-old Kermanshah students was higher than the WHO standards. In order to improve the current situation، a proper programming seems necessary. Furthermore، more attention must be paid to the education of families about dental and oral health and preventive dentistry. This education can be implemented through the media، health care centers and health supervisors in schools.

Diabetes is a serious problem and self- management is effective factor for diabetes control. Social support is one of the important factors in diabetes self-management. In this study، purpose was determination of effective support resources in self- management. Data were collected from a convenience sample of 396 diabetic patients، using self- management and social support resources in chronic patient scales. For data analysis with SPSS version 16، multiple linear regression models were used. Among six support resources، maximum support was provided by personal adaptation، health provider، and family/ friends resources (R2= 43%). Personal adaptation was significant predictor for all of self- management aspects except monitoring blood glucose. Health provider was effective factor in self- regulation and interaction with health provider، and family/ friend resource were significant predictors for self- integration، self- regulation، and interaction with health provider. Diabetic patients impart of poor resources for self- management. Personal adaptation was the most important source of self- management and media/ policy، work place، and health organization supports were not effective source for this purpose. Therefore، preparation of this resource may improve diabetes self- management.

Electro-Convulsive Therapy (ECT) is one of the most effective treatments in psychiatry. The aim of this study is to survey the Electro-Convulsive Therapy (ECT) practice in department of psychiatry، Bushehr Port University of Medical Sciences (BPUMS)، Bushehr، Iran in 2008 to 2010. In this retrograde study all the patients that had been admitted in department of psychiatry of Fatemeh Zahra Hospital during 2008 to 2010 and had received ECT، were included. The patients were studied to survey their clinical diagnosis and epidemiological data. Statistical analysis conducted using SPSS software version 12. Of 801 patient that were admitted، 254 (31. 7%) had received ECT. Clinical diagnoses of the patients received ECT according to their frequency included schizophrenia (33. 1%)، Bipolar Mood Disorder (BMD) (32. 6%)، Major Depressive Disorder (MDD) (13. 7%)، schizoaffective (11. 4%)، drug abuse (4. 7%) and others. Male to female ratio of ECT receivers was 1. 5 to 1. The mean age of the subjects was 34. 5 year. The average number of ECT sessions for each patient was 7. 4. The rate of ECT practice among psychiatry inpatients in department of psychiatry of BPUMS is high comparing to other psychiatry centers. Patients with schizophrenia in contrast to MDD were the most common group that received ECT. The reason for our findings needs to be surveyed in other studies.

Subclinical hyperthyroidism occurs when peripheral thyroid hormone levels are within the normal labaratory reference range and serum thyroid stimulating hormone level is less than normal. For patients with sustained subclinical hyperthyroidism (serum TSH level< 0/1mlu/L)، therapy is recommended especially in older patients. Observation or selective therapy should be considered for patients with: Serum TSH level between 0/1 and 0/4 mlu/L and postmonoposel osteoprosis، recent atrial fibrillation congestive heart failure، angina pectoris and infertility or menstrual disorder. This review article aimed to assess the indication of treatment of the patients with subclinical hypothyroidism. The sample size of this study was the article index in block cochrance، embase، pubmed databases and enutained the terms subclinical hyperthyroid، thyroxin، and thyrotropin. 209 articles were found that 53 articles were investigated for this issue. The results are discussed under the subtitles such as subclinical hypothyroidism and indication of treatment of subclinical hyperthyroidism. In this summary، we tried to review the current literature about subclinical hyperthyroidism and indication of treatment of subclinical hyperthyroidism.